Korean J Intern Med.  2019 Nov;34(6):1223-1232. 10.3904/kjim.2018.058.

Clinical outcomes of patients with a single hepatocellular carcinoma less than 5 cm treated with transarterial chemoembolization

• Baek MY
• Yoo JJ
• Jeong SW
• Jang JY
• Kim YK
• Jeong SO
• Lee SH
• Kim SG
• Cha SW
• Kim YS
• Cho YD
• Kim HS
• Kim BS
• Kim YJ
• Park SY

• KMID: 2463480
• DOI: http://doi.org/10.3904/kjim.2018.058

Abstract

BACKGROUND/AIMS
Transarterial chemoembolization (TACE) is performed for single hepatocellular carcinoma (HCC) that are not eligible for surgery or ablation therapy. We investigated the clinical outcomes of patients with a single HCC ≤ 5 cm treated with TACE.
METHODS
This study analyzed 175 consecutive patients who underwent TACE as an initial treatment for single HCC ≤ 5 cm. Predictive factors for complete response (CR), recurrence after CR, and overall survival (OS) were evaluated.
RESULTS
Total 119 patients (68%) achieved CR after TACE. Tumor size < 3 cm and hepatitis B virus infection were significant predictors of CR (p < 0.05). Recurrent HCC was detected in 73 patients (61.3%) after CR. Age > 65 years and absence of liver cirrhosis were predictive factors for non-recurrence after CR (p < 0.05). The OS for all patients was 80.7 ± 5.6 months, and the 1-, 3-, and 5-year OS rates were 88.1%, 64.8%, and 49.9%, respectively. In multivariate analysis for OS, CR (hazard ratio [HR], 0.467; 95% confidence interval [CI], 0.292 to 0.747) and Child class A (HR, 0.390; 95% CI, 0.243 to 0.626) were significant factors. The OS for the CR and Child class A group were 92 and 93.6 months, respectively, and that of the non-CR and Child B, C group were 53.3 and 50.7 months, respectively (p < 0.001).
CONCLUSIONS
TACE can be a valid treatment in patients with a single HCC ≤ 5 cm not suitable for curative treatment, especially in patients with Child class A and CR after TACE.

Keyword

Carcinoma, hepatocellular; Chemoembolization, therapeutic; Survival

MeSH Terms

Carcinoma, Hepatocellular*
Chemoembolization, Therapeutic
Child
Hepatitis B virus
Humans
Liver Cirrhosis
Multivariate Analysis
Recurrence